University Medical Center of El Paso
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Dir. Provider Relations, Contracting & Credentialing, EPH
at University Medical Center of El Paso
Responsible for the overall planning, organization, and direction of the health plan’s Provider Relations, Contracting and Credentialing functions. Assures compliance with all network management and credentialing standards set forth by Federal, State and National regulatory and accreditation entities such as the Texas Health and Human Services Commission, Centers for Medicare & Medicaid Services, Texas Department of Insurance, URAC, and the National Committee for Quality Assurance. Researches and assesses provider network needs and develops strategies to meet network operational requirements and goals. Supervises Associates in the Provider Relations and Contracting and Credentialing departments.
1. Excellent communication (verbal, written, interpersonal) skills with the ability to deliver well-defined information to all level of management and staff.
2. Ability to work successfully at a self-directed pace in a changing, high demand environment.
3. Leadership ability, communications, and interpersonal skills necessary to interact effectively with Physicians and external agencies/customers.
4. Proven organization and contract management skills.
5. In-depth knowledge of community/state health care resources.
6. Must be an effective leader and motivator of people with varying skill levels.
7. Ability to work successfully under tight deadlines.
8. Ability to make timely decisions with appropriate information and consultation.
9. Bilingual: English and Spanish preferred.
Five years of management/supervisory experience required. Strong background in provider relations, provider contracting and credentialing, preferred. Experience in a managed care or insurance environment, preferably in Medicaid or Medicare Advantage. Proficiency with Microsoft Word, Excel, and Access database software and as well as proven project management skills preferred.
Education and Training:
Bachelor degree in Healthcare, Business Administration, or related field required.